The epidemiology of depression and the scope for preventive intervention

  • Note: this is a past research project that is now complete. 

    Aim

    The primary objective of this project, supported by an NH&MRC Public Health (Australian) Fellowship, is to examine the epidemiology of depression, suicide and suicidal behaviour in young people and the scope for preventive intervention.

    Project Description

    Recommendations from the National Health and Medical Research Council suggest that the epidemiological study of adolescent depression and related behaviours (such as youth suicide and alcohol and drug use) should take precedent in Australian research. Depressive symptoms become prominent in the transition period between pre-puberty and mid adolescence and it is now clear that first episodes of depression most commonly begin in young people. Depression's common occurrence with other psychiatric disorders and parallel trends linking adolescent depression, suicidal ideation and attempts, poor outcomes such as school failure and the uptake of unhealthy and socially damaging behaviours (such as alcohol and substance use) have prompted questions about causality. Other findings from retrospective and prospective clinical studies which require clarification in an Australian context are the continuities between adolescent psychopathology and later adult disorders or poor health outcomes and the risk and protective factors which influence progression or remission in behaviour and psychopathology.

    Examining the distribution and strength of adolescent emotional problems and research promoting clarification of the complexity of the risk processes and the probable range of modifying influences can help shape intervention programs, their timing and focus during the period of adolescent development.

    The Victorian Adolescent Health Cohort Study (VAHCS) provides a reliable source of data which is being analysed to examine the following;

    • the prevalence of suicidal behaviour, depression and health related problems across the developmental spectrum (adolescence and the transition period from late adolescence to early adulthood).
    • the strength, pattern and causal relationships of risk and protective factors associated with suicidal behaviour, adolescent depression and health related problems in early adulthood.
    • the continuities between suicidal behaviour, depression and health related problems during adolescence and disorders and poor health outcomes in early adulthood.


    This information will be used to help inform the consideration of strategies employed in the implementation of preventive interventions to reduce rates of youth suicide and depression.

    The Gatehouse Project is a randomised controlled trial of a population based intervention program designed to prevent adolescent depression and related problems. Baseline and follow-up data has been collected from students in year 8, year 9 and year 10 (1997, 1998 & 1999) with intended follow-up occurring again in the year 2000. The data collected from this project is being used to examine associations between depression, deliberate self harm and the social environments of young people.

    Publications

    • Burns J, Sanci, L. Youth Suicide: A risk factor based approach to prevention. Medical Observer. Continuing Medical Education Program (invited paper, 7 August 1998).
    • Burns JM, Patton GC. Preventive Interventions for Youth Suicide: a risk factor based approach. Australian and New Zealand Journal of Psychiatry (2000) 34:388-407.
    • Patton G, Burns J. Scope for preventive intervention in youth suicide: a risk factor based approach. Report prepared for the National Health and Medical Research Council (1997)
    • Patton G, Burns J. The effectiveness and cost-effectiveness of preventive intervention for youth suicide: a risk factor based approach. Report prepared for the Commonwealth of Australia (1998).
    • Patton G, Carlin J, Coffey C, Burns J, Wolfe R. Initiation, remission and relapse of early onset depression: a six wave prospective population-based study. Psychological Medicine (under review).

    In preparation

    • Burns J, Coffey C, Channan A, Patton G. Non-Fatal Suicidal Behaviour in a Representative Cohort of Victorian Adolescents.
    • Burns JM, Druitt ML, Coffey C, Patton GC. A brief rating of adolescent self harm (BRASH) in a population based study.
    • Dudley M, Martin G, Hazell P, Burns J, Cantor C, DeLeo D. Evidence-based approaches for mental health professionals managing non-fatal deliberate self-harm in young people.
    • Lee DHS, Burns J, Bond L, Patton G. Social determinants of adolescent deliberate self-harm in a population based study.